Men who experience high levels of anxiety and emotional distress over a prostate cancer diagnosis are more likely to choose unnecessary treatment options, according to a new study by researchers at the University at Buffalo (UB) and Roswell Park Cancer Institute.
“Emotional distress may motivate men with low-risk prostate cancer to choose more aggressive treatment, such as choosing surgery over active surveillance,” said lead author Heather Orom, Ph.D., associate professor of community health and health behavior in UB’s School of Public Health and Health Professions.
“It underscores what we have been pushing a long time for, which is, ‘Let’s make this decision as informed and supported as possible.’ If distress early on is influencing treatment choice, then maybe we help men by providing clearer information about prognosis and strategies for dealing with anxiety. We hope this will help improve the treatment decision making process and ultimately, the patient’s quality of life.”
The study involved 1,531 men with newly diagnosed, clinically localized prostate cancer — meaning the disease hadn’t spread to other parts of the body. The majority of study participants had either low- or intermediate-risk disease, and were more likely to have been treated with surgery, followed by radiation and active surveillance.
Using an 11-point scale ranging from zero (no distress) to 10 (extreme distress), researchers twice measured the patients’ emotional distress — shortly after their diagnosis and again right after they had made their treatment decision.
“Men’s level of emotional distress shortly after diagnosis predicted greater likelihood of choosing surgery over active surveillance,” said the researchers. “Importantly, this was true among men with low-risk disease, for whom active surveillance may be a clinically viable option and side effects of surgery might be avoided.”
Although prostate cancer is considered a serious disease, it is not a death sentence, according to the American Cancer Society, which estimates there are nearly three million prostate cancer survivors alive today.
Over-treatment is a valid concern for many prostate cancer patients. In particular, surgery and radiation therapy have side effects such as erectile dysfunction and incontinence, and the majority of men diagnosed with low-risk prostate cancer can avoid these issues by choosing active surveillance to monitor the cancer and then choose treatment if the disease progresses.
“The goal of most physicians treating men with prostate cancer is to help their patients and family members through a difficult process and help their patients receive appropriate treatment,” said Willie Underwood III, M.D., MS, MPH, an associate professor in Roswell Park’s Department of Urology, and a paper co-author.
“To do so, it is helpful for physicians to better understand what is motivating men’s decisions and to address negative motivators such as emotional distress to prevent men from receiving a treatment that they don’t need or will later regret.”
The findings are published in the Journal of Urology.
Source: University at Buffalo